Empiric-atb081208-angol.xls

Empiric antibiotic therapy of bacterial infections – first choice antibiotics in Hungary
Most important pathogens
RESPIRATORY TRACT
TONSILLITIS FOLLICULARIS
penicillin (or other ß-lactam), penicillin allergy: macrolide Upper respiratory tract inf.: Acute otitis media, sinusitis (virus), S.pneumoniae, H. influenzae,
Epiglottitis
Bronchitis acuta
Chlamydia pneumoniae, (B.pertussis?) Pneumonia
ATYPICAL
- <65 years old, no underlying condition amoxicillin+clavulanic acid / macrolide / C.pneumoniae, H. influenzae, (virus) - >65 y old / underlying condition / severe form, S.pneumoniae, H. influezae, Gr – rods, S. Ceftriaxon OR cefepimOR piperacillin + tazobactam, + macrolide OR FQ metronidazoleclarithromycin OR amox/clav, severe: Pneumonia in newborn and infant
M. pneumoniae, C. pneumoniae, (virus) Lung abcess, other abcesses
Infections of the oral cavity
Diphtheria
antitoxin,macrolide or penicillin: effective in the first few days after infection Pertussis
supportive th. - erythromycin on the first days Tuberculosis
INH + etambuthol + rifampicin + pyrazinamid for 2 month - INH + rifampicin for 4 month Most important pathogens
INTRACARDIAL INFECTIONS
Endocarditis
antibiogram!
penicillin, ceftriaxon, penicillin + aminoglycoside Endocarditis prophylaxis (obligatory for patients with
arteficial heart valves or known structural abnormalities of the heart valves, before invasive procedures) ABDOMINAL INFECTIONS
H.pylori infection
proton pump inhibitor + clarithromycin/ amoxicillin + metronidazole Salmonellosis
Typhus abdominalis (typhoid fever)
fluoroquinolone (for children: 3. gen. cephalosporin) Campylobacter infection
Replacement of fluids and electrolytes (erythromycin) Shigellosis
S.dysenteriae, flexneri, boydii, sonnei Replacement of fluids and electrolytes + FQ (for children: ampicillin) Traveller's diarrhea
E. coli, Salmonella, Shigella, … Replacement of fluids and electrolytes (+FQ) Replacement of fluids and electrolytes (ORS) + FQ Cholecystitis
Pseudomembranosus colitis
Intraabdominal infections, peritonitis
polymicrobial: E.coli, Enterobacteriaceae, OR 2., 3. gen. cephalosporinsOR fluoroquinolones + Metronidazole Most important pathogens
INFECTIONS OF THE GENITO-URINARY TRACT
CYSTITIS, PYELONEPHRITIS
E.coli, Proteus, Klebsiella, Enterococcus, fluoroquinolon (amoxicillin+calvulanic acid / Prostatitis
Bacteroides, Enterobacteriaceae … Pelvic Inflammatory Disease
Bacteroides, Enterobacteriaceae … Gonorrhoea
single dose of fluoroquinolone, ceftriaxon SYPHILIS
penicillin (allergic patient: tetracyclin) Bacterial vaginosis
polimicrobial (Gardnerella, Mycoplasma, Prevotella) Chlamydia trachomatis urethritis
SKIN AND SOFT TISSUE INFECTIONS
Impetigo
ERYSIPELAS
GAS GANGRENE
surgical, penicillin + clindamycin, metronidazole Fasciitis necrotisans
Lyme disease
Osteomyelitis
S.aureus, Streptococcus, Gr neg. Rods… Decubitus
polymicrobial (S.aureus, Proteus, E.coli, INFECTIONS OF THE CENTRAL NERVOUS SYSTEM
Meningits
N.menigitidis, S.pneumoniae, H.influenzae, III. gen. cephalosporin + aminopenicillin L.moncytogenes, E.coli… Listeriosis affecting the CNS
Lyme disease affectinfg the CNS
Tularaemia
Brucellosis
Leptospirosis

Source: http://mikrobiologia.sote.hu/doksi/help/empiric-atb_th_2009-HAangol.pdf